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Bilateral iliococcygeus fixation technicque for enterocele and vaginal vault prolapse repair
HAIM KRISSI1, STUART L STANTON21Pelvic Reconstruction & Urogynaecology Unit, Department of Obstetrics and Gynecology, St. George ’s Hospital, London, UK.; Department of Obstetrics and Gynecology, Beilinson Hospital, Petah-Tıqva, and Sackler Faculty Of Medic, 2Pelvic Reconstruction & Urogynaecology Unit, Department of Obstetrics and Gynecology, St. George ’s Hospital, London, UK.
OBJECTIVE: :To evaluate our surgical experience with iliococcygeus fixation for enterocele and vaginal vault prolapse repair. DESIGN: Prospective longitudinal study. SETTING: Tertiary care referral centre, St. George’s Hospital, London.
METHOD: :Comprehensive questionnaire for pre- and postoperative prolapse, urinary, bowel, and sexual symptoms, a pre and postoperative site-specific vaginal examination following the standardized International Continence Society scoring for prolapse, preoperative urodynamic studies, analysis of surgical results. POPULATION: 32 consecutive women who underwent bilateral iliococcygeus fixation. OUTCOME MEASURES: Feasibility of the procedure, intra- and postoperative complications, short-term postoperative prolapse-associated symptoms and pelvic organ prolapse quantification.
RESULTS: :Three patients were lost for follow-up. The mean postoperative follow up for the reminder 29 patients (90.6%) was 11.5±6.25 months (range 6-25). Twenty-five patients (78.1%) had a previous hysterectomy. Concomitant surgery was performed in 30 patients (93.7%). The iliococcygeus fixation was completed successfully in all cases. The mean blood loss per surgical procedure was 224±104 ml (range 100-400). There were no intraoperative complications. Postoperatively, one patient needed a blood transfusion, one had transitory left leg pain, and four had temporary voiding difficulty. The mean hospitalization time was 4.5±1.9 days (range 3-9). There was a statistically significant improvement in all pelvic organs prolapse quantification measurements (p<0.0001). Three patients (10.3%) had recurrence of vault prolapse or enterocele. The mean total vaginal length was shorter postoperatively (7.2±0.8 cm versus 8.6±1.0 preoperatively, p<0.001).
CONCLUSIONS: :iliococcygeus fixation is a relatively safe vaginal surgery for the treatment of enterocele and vaginal vault prolapse.
Cite This Article
KRISSI H, STANTON S. Bilateral iliococcygeus fixation technicque for enterocele and vaginal vault prolapse repair. 2010; 29(1): 11-14
Corresponding Author: KRISSI H.
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